NABH Pre-Accreditation Entry-Level Standards: Using Software for Help

The National Accreditation Board for Hospitals and Health Care Providers (NABH) has now given standards that need to be followed before applying for accreditation. The Indian Medical Association recommends these standards too. The standards might become mandatory for insurance companies for empanelling, and the state Governments might eventually make them mandatory for all healthcare facilities.

The NABH Standards

The NABH entry-level standards can be used as a starting point for smaller hospitals that cannot meet the strict requirements for full accreditation. The full set of NABH standards includes 102 standards and 636 “objective elements,” and the standards are recognized by the International Society for Quality in Healthcare (ISQua). For hospitals with 50 beds, there are 45 standards and 173 objective elements, and for those under 50 beds, only 41 standards and 149 objective elements must be met. Recently only about 227 hospitals were fully NABH accredited, with roughly 1200 more in the application process. (1)
For hospitals with less than 50 beds, most of the standards are achievable with the help of good Hospital Management software. At SEESHA Karunya community hospital we developed software which makes compliance with NABH standards easy.

The Standard and Software

AAC (Access, Assessment and Continuity of Care) – The AAC section requires proper consent forms and documentation, which is easier to do with the software. For instance:

1. The correct consent forms with the right wording are automatically generated, based on the age of the patient or with a single click/entry for differently able.
2. The consent form and the initial assessment form that is signed are scanned into the software for records and easy re-calls. The costs of various types of treatment are easy to generate with the software and could be explained to the patients while also getting the necessary signatures.
3. The software generates all of the necessary forms, according to the NABH requirement with just a click.
4. The printouts of specific instructions, complications, etc. are generated as the various procedures are posted.
5. There is a facility for ordering a standard set of investigations for a provisional diagnosis that is made, so that tests are not missed, and similarly, with diagnosis the standard medicines and instructions can be generated with just a click, thus making these actions fast and making sure none of the instructions or medicines are missed.
6. Once entered, the information can be used for all of the necessary forms, rather than writing them again. For instance, once the clinical presentation is typed in after the initial assessment at the OPD, it could be used for the admission forms, discharge summary, etc., and the software could generate the variety of discharges and forms for transfer that are necessary.

COP (Continuing Care of Patients)

7. Health education and other instructions for the diagnosis made are also generated, specific to the diagnosis, making it easy for the doctors to explain.
8. The software helps to give appropriate heath education materials for a variety of diagnoses, explaining the various conditions in a language that patients can understand. They were written by experts in the field, and all of the doctors will have the benefit of their expertise. The software also helps the hospital generate the various protocols necessary for continuing care of patients.
9. The software helps to fill the frequently repeated advice and health education materials, operation notes, etc. with wise search and fill-in options. As you type similar words, previously typed options appear, and the entire portion can be added with just a click.

MANAGEMENT OF MEDICINES (MOM)

10. The use of computer software helps the most at the Pharmacy (2). In more than 10 hospitals in Northeast India, the income from the Pharmacy doubled after installing the software. This was because of various reasons like:

there was no wastage due to expiry of medicines

the correct amounts were ordered

strict control measures were possible due to ABC analysis of medicines, etc.

PATIENTS’ RIGHTS

11. Without the reminder from the computer printout with each in-patient record, it would be very difficult to explain about the patients’ rights to the admitted patients and their relatives.

HOSPITAL INFECTION MANAGEMENT

12. The computer software helps to keep track of all of the hospital infections and management.

QUALITY IMPROVEMENT

13. The computer software helps to analyze over 30 parameters that improve understanding of the efficiency of the various aspects of hospital management.
14. To manually do the required analysis would be time-consuming and difficult.

RESPONSIBILITIES OF MANAGEMENT

15. The software helps to keep the records of the various committee meetings that are concerned with management of...